Organization
SKILLED WOUND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARDIA ANVAR MD (PRESIDENT)
(310) 445-5999
Entity
Organization
Contact information
Practice address
12021 WILSHIRE BLVD # 745, LOS ANGELES, CA 90025-1206
(310) 348-1900
Mailing address
12021 WILSHIRE BLVD STE 745, LOS ANGELES, CA 90025-1206
(310) 348-1900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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